Individual
LESLIE BAUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
45 MAPLE ST, DANSVILLE, NY 14437-9182
(585) 335-5052
Mailing address
10319 FREINER HILL RD, CANASERAGA, NY 14822-9757
(607) 281-5479
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
640861
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
161039939
ALL OTHER INSURANCES
NY
05
—
161039939
—
NY
Enumeration date
03/22/2021
Last updated
03/22/2021
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